Background: COVID-19 pandemic has presented unprecedented challenges to global healthcare systems, particularly in resource-limited settings like Palestine. Identifying clinical, demographic, and laboratory predictors of in-hospital mortality is crucial for improving outcomes, guiding treatment, and optimizing resource allocation.

Objectives: This study aimed to determine the key demographic, clinical, laboratory, and treatment-related factors associated with in-hospital mortality among COVID-19 patients admitted to six governmental hospitals across the West Bank, Palestine.

Methods: A retrospective cohort design was employed using data from 200 confirmed COVID-19 patients hospitalized between November 1, 2020, and February 1, 2021. Bivariate analyses were conducted using Chi-square and t-tests. Statistically significant variables (p < 0.05) were entered into logistic and Cox regression models to identify independent predictors of mortality and time to death.

Results: The overall In-hospital mortality rate was 43%. Obesity was the strongest predictor of mortality (OR = 5.73, p < 0.001; HR = 2.66, p < 0.001). Pregnant women showed alarmingly high mortality (81%), though this did not remain significant in multivariate analysis due to small sample size. Widowed patients were significantly more likely to die (HR = 2.77, p = 0.019), emphasizing the role of social support. Hospital type was another independent predictor, with patients at Dura Hospital experiencing higher odds of death (OR = 3.26, p = 0.017). Key laboratory findings included significantly lower PaO₂, serum creatinine, and random blood sugar levels among non-survivors. Actemra (tocilizumab) use was associated with significantly lower mortality (0% vs. 46%, p = 0.001), while vancomycin and ceftriaxone were associated with higher mortality, likely reflecting use in severe cases.

Conclusions: This study identified key predictors of COVID-19 mortality in Palestine, emphasizing the need to prioritize high-risk groups such as obese and pregnant patients. The findings highlight disparities between hospitals and reinforce the importance of standardizing care across healthcare facilities. These insights can help shape evidence-based health policies tailored to the Palestinian context and could serve as a foundational dataset for preparedness in future pandemics or resurgences of COVID-19.

Title

Front. Med

Publisher

Frontiers Media SA

Publisher Country

Switzerland

Indexing

Thomson Reuters

Impact Factor

3.0

Publication Type

Online only

Volume

12

Year

2025

Pages

Volume 12 - 2025